title: A cross-sectional study examining Australian general practitioners' identification of overweight and obese patients.
abstract: BACKGROUND
  Overweight and obese patients attempt weight loss when advised to do so by their physicians; however, only a small proportion of these patients report receiving such advice. One reason may be that physicians do not identify their overweight and obese patients.
  
  
  OBJECTIVE
  We aimed to determine the extent that Australian general practitioners (GP) recognise overweight or obesity in their patients, and to explore patient and GP characteristics associated with non-detection of overweight and obesity.
  
  
  METHODS
  Consenting adult patients (n = 1,111) reported weight, height, demographics and health conditions using a touchscreen computer. GPs (n = 51) completed hard-copy questionnaires indicating whether their patients were overweight or obese. We calculated the sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) for GP detection, using patient self-reported weight and height as the criterion measure for overweight and obesity. For a subsample of patients (n = 107), we did a sensitivity analysis with patient-measured weight and height. We conducted an adjusted, multivariable logistic regression to explore characteristics associated with non-detection, using random effects to adjust for correlation within GPs.
  
  
  RESULTS
  Sensitivity for GP assessment was 63 % [95 % CI 57-69 %], specificity 89 % [95 % CI 85-92 %], PPV 87 % [95 % CI 83-90 %] and NPV 69 % [95 % CI 65-72 %]. Sensitivity increased by 3 % and specificity was unchanged in the sensitivity analysis. Men (OR: 1.7 [95 % CI 1.1-2.7]), patients without high blood pressure (OR: 1.8 [95 % CI 1.2-2.8]) and without type 2 diabetes (OR: 2.4 [95 % CI 1.2-8.0]) had higher odds of non-detection. Individuals with obesity (OR: 0.1 [95 % CI 0.07-0.2]) or diploma-level education (OR: 0.3 [95%CI 0.1-0.6]) had lower odds of not being identified. No GP characteristics were associated with non-detection of overweight or obesity.
  
  
  CONCLUSIONS
  GPs missed identifying a substantial proportion of overweight and obese patients. Strategies to support GPs in identifying their overweight or obese patients need to be implemented.
authors.affiliation: Priority Research Centre for Health Behaviour and Hunter Medical Research Institute, The University of Newcastle, Callaghan, NSW, 2308, Australia, Sze.Yoong@newcastle.edu.au.
authors.forename: Sze Lin
authors.initials: SL
authors.lastname: Yoong
authors.forename: Mariko Leanne
authors.initials: ML
authors.lastname: Carey
authors.forename: Robert William
authors.initials: RW
authors.lastname: Sanson-Fisher
authors.forename: Catherine Anne
authors.initials: CA
authors.lastname: D'Este
authors.forename: Lisa
authors.initials: L
authors.lastname: Mackenzie
authors.forename: Allison
authors.initials: A
authors.lastname: Boyes
mesh_terms: D000328:Adult; D000368:Aged; D001315:Australia / Q000453:epidemiology; D002983:Clinical Competence / Q000592:standards*; D003430:Cross-Sectional Studies; D005260:Female; D058005:General Practitioners / Q000592:standards*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000175:diagnosis* / Q000453:epidemiology*; D050177:Overweight / Q000175:diagnosis* / Q000453:epidemiology*; D011795:Surveys and Questionnaires / Q000592:standards